ReviewBiology of sex differences2025
Understanding sex and gender disparities in COVID-19 mortality: a narrative review beyond biology.
Review in Biology of sex differences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Transdermal 17β-Estradiol for the Treatment of COVID-19: Protocol of an Early Terminated Phase 2 Randomized Controlled Trial.JMIR research protocols · 2026Article
- Brain corticogenesis promotes SARS-CoV-2 neuro-glial tropism through lipid-dependent viral replication.Stem cell reports · 2026Article
- An approach to assess the impact of measures mitigating burden associated with COVID-19 in Central Asia (Kazakhstan, Kyrgyzstan, Mongolia).Scientific reports · 2026Article
- The association between smoking and COVID-19 symptoms, severity, and post-COVID-19 symptoms: a cross-sectional survey study.Frontiers in public health · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMen have consistently experienced higher COVID-19 mortality than women across most countries and time periods, prompting widespread investigation into potential biological causes. Early research focused on sex-related genetic, hormonal, and immunological mechanisms to explain these disparities. MAIN BODY: This narrative review traces the evolution of scientific explanations for women/men mortality differences in COVID-19, from early biological hypotheses to more nuanced gendered and intersectional models. While some studies suggest sex-linked genetic variants, chromosomal mechanisms, or hormone-regulated expression of viral entry receptors might partially explain men's higher mortality, the overall evidence remains inconsistent and inconclusive. Increasingly, attention has shifted to social and structural factors, including occupational exposure, pre-existing health conditions, healthcare access, and behaviors, that can differently shape vulnerability to COVID-19 in women and men. Data disaggregated by gender and race further revealed significant heterogeneity in outcomes, underscoring the influence of intersecting axes of inequality. International comparisons suggested that gender inequality at the societal level was associated with wider women/men COVID-19 mortality gaps. Analyses that overlook the interaction between sex- and gender-related factors and their intersection with racial disparities and socioeconomic status risk obscuring the underlying drivers of COVID-19 disparities.
conclusionSex-related biological factors may have influenced COVID-19 outcomes, but they do not adequately account for the observed differences in mortality between women and men. Approaching the study of health inequities through a gendered, intersectional framework is essential for accurately identifying and addressing underlying risk factors, and for better understanding how sex- and gender-related factors may interact, not only in COVID-19, but across a broad range of health conditions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.